When she had concerns about Zola, Janet Meyers asked Ruth to page Derek several times, saying it was very important. Ruth informed her that as he was a neurosurgeon, everyone paging him thought it was very important. She told Janet she'd let her know when he called back. ("She's Gone")

When Meredith and Lexie questioned whether or not they should remove Lori Bosson's tumor, they asked Ruth to check on Derek's progress. She told them he'd almost finished and would be back any minute. ("One Step Too Far")

When several nurses threatened to quit over new Pegasus policies, which involved working split shifts, Ruth, after Owen's speech, was willing to give it a try and encouraged others to do the same. ("Hard Bargain")

After the hospital was purchased by several of the doctors, Ruth was trying to get some of the nurses who had quit to come back, but noted that some of them were bitchier than she is. ("Transplant Wasteland")

After Meredith's fall in the stairwell, Ruth went to inform Derek about what had happened, although she confirmed Meredith was doing okay, but on her way to OB to get the baby checked. ("Readiness is All")

Leah Murphy and Ruth entered Jimmy's room, where he was deteriorating. Ruth put on an oxygen mask, while Leah diagnosed him with an MI. She asked for an ECG and a crash cart while Leah paged Cristina Yang. Later Shane Ross arrived and planned to operate on Jimmy. Leah said that she only paged him to get Yang, who was Jimmy's doctor. Shane said that Yang was at the wedding, and he was there now. Shane said he knew what he was doing, as he'd treated Jimmy before. When Leah protested, Ruth agreed with her and suggested on waiting for an attending when Shane asked Ruth to have an OR cleared for a sternotomy. When Ruth protested, Shane threatened her with having a dead patient on her hands, so she cleared an OR. ("Get Up, Stand Up")

During a virus outbreak, Ruth came to find Derek, who was practicing his speech, saying he was needed to operate even though he wasn't on call because everyone else was sick. She then saw that he was also sick, something he denied. ("You Be Illin'")

When a heart became available for Link McNeil, Cristina planned to stay for the surgery, but she was forced to hand it over to Maggie when Ruth came in and told her that the heart was delayed in traffic. ("Fear (of the Unknown)")